BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                      



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          |SENATE RULES COMMITTEE            |                   SB 923|
          |Office of Senate Floor Analyses   |                         |
          |1020 N Street, Suite 524          |                         |
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                                 THIRD READING


          Bill No:  SB 923
          Author:   De León (D)
          Amended:  5/3/11
          Vote:     21

           
           SENATE LABOR & INDUSTRIAL REL. COMMITTEE  :  6-0, 4/27/11
          AYES:  Lieu, Wyland, DeSaulnier, Leno, Padilla, Runner
          NO VOTE RECORDED:  Yee

           SENATE APPROPRIATIONS COMMITTEE  :  9-0, 5/26/11
          AYES:  Kehoe, Walters, Alquist, Emmerson, Lieu, Pavley, 
            Price, Runner, Steinberg


            SUBJECT  :    Workers compensation:  official medical fee:  
                      schedule: physician services

           SOURCE  :     Author


           DIGEST  :    This bill requires the Administrative Director 
          (AD) of the Division of Workers Compensation, by January 1, 
          2013, to adopt an Official Medical Fee Schedule (OMFS) for 
          physician services based on the resource-based relative 
          value scale.  This bill requires the AD, on or after 
          January 1, 2014, and no less frequently than biennially, to 
          revise the OMFS.  

           ANALYSIS  :    Existing law establishes a workers' 
          compensation system, administered by the AD of the Division 
          of Workers' Compensation (DWC), to compensate an employee 
          for injuries sustained in the course of his/her employment.
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          Existing law requires the AD, after public hearings, to 
          adopt and revise periodically an official medical fee 
          schedule that establishes reasonable maximum fees paid for 
          medical services, other than physician services, and other 
          prescribed goods and services, in accordance with specified 
          requirements.

          Existing law, notwithstanding the above provisions, further 
          authorizes the AD, after public hearings, to adopt and 
          revise, no less frequently than biennially, an official 
          medical fee schedule for physician services, in accordance 
          with specified requirements.

          This bill requires the AD, by January 1, 2013, to adopt an 
          OMFS for physician services based on the resource-based 
          relative value scale.  This bill requires the AD, on or 
          after January 1, 2014, and no less frequently than 
          biennially, to revise the OMFS.  

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes   
          Local:  No

          According to the Senate Appropriations Committee:

                         Fiscal Impact (in thousands)

           Major Provisions      2011-12     2012-13    2013-14     Fund  

          Annual updating of                                
          OMFS                                                   
            - initial implementation     $500 to $700       
          Special*
              (rule making and study)
           
           -  biennial revision                             Up to 
          $100                 Special*

          Change in reimbursement        Unknown, increase or 
          decrease over        General/
          rates for medical services     current reimbursement 
          rates paid by        Special
                               employers, including the state








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          * Workers' Compensation Administrative Revolving Fund

           SUPPORT  :   (Verified  5/31/11)

          California Occupational Medicine Physicians
          Kaiser Permanente
          U.S. Health Works
          Western Occupational and Environmental Medical Association

           OPPOSITION  :    (Verified  5/31/11)

          California Orthopedic Association

           ARGUMENTS IN SUPPORT  :    Proponents argue that this bill 
          requires a long-overdue conversion of the workers' 
          compensation fee schedule to a schedule based on 
          Resource-Based Relative Value Scale (RBRVS) utilized by the 
          Medicare system.  Proponents note that the existing system 
          is antiquated and based on valuations and assumptions that 
          are out-of-date and place primary treating physicians at a 
          disadvantage.  Proponents also note that an RBRVS-based 
          schedule would be simpler and easier for employers and 
          payor to comply with.

           ARGUMENTS IN OPPOSITION  :    Opponents argue that, while an 
          RBRVS-system has considerable merit, this bill 
          significantly increases reimbursement rates for physicians, 
          increasing costs on employers and would endanger efforts to 
          increase workers' compensation benefits for seriously 
          injured workers.  Opponents also note that increasing 
          reimbursement rates for certain specializations could 
          create perverse incentives for unnecessary medical 
          procedures, which would not be beneficial for injured 
          workers.  Finally, opponents argue that the DWC is 
          empowered to create a RBRVS-based Official Medical Fee 
          Schedule, and the future AD of the DWC should be given the 
          chance to do so. 
           

          PQ:kc  5/31/11   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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